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Physical Therapists and the Chiropractic Practice Act. Denise Natale, D.C. Vermont Board of Chiropractic. History. March 2005 PT Advisor Board proposes “housekeeping” changes to practice act, including adding mobilization April 2005 VCA responds with concerns July 2005

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Physical Therapists and the Chiropractic Practice Act

Denise Natale, D.C.

Vermont Board of Chiropractic


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History

  • March 2005

    • PT Advisor Board proposes “housekeeping” changes to practice act, including adding mobilization

  • April 2005

    • VCA responds with concerns

  • July 2005

    • PT publishes draft language for proposed act


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History

  • September 2005

    • PT responds to VCA April 2005 letter, claiming qualifications

  • November 2005

    • PT requests meeting with VT Board to discuss definitions of manipulation, mobilization

  • December 2005

    • PT and VT Board meet for fact-finding


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History

  • January 2006

    • PT’s invited back to VT Board

    • PT’s respond with letter


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The Problems

  • PT’s offer language from their Federation of State Board of Physical Therapy Model Practice Act


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The Problems

  • OPR/Legislator confusion

    • Both PT’s and DC’s offer their version of the truth

  • The PT language offers mobilization and manipulation as synonyms


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The Problems

  • No good universal definition of manipulation, mobilization seemed to exist

    • Many suggested definitions are

      • Politically motivated

      • Old chiropractic dogma

      • Not reflective of current, unbiased science

      • Not defensible in court


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The Problems

  • Compared to the extensive background work PT’s have conducted, DC’s are not prepared to defend their practice to legislators


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The Problems

  • To stay out of the “turf war” trap

    • This is not about politics

    • This is a public protection issue


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The Problems

  • We need resources!!!


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Concerns Raised by Colleagues

  • % of PT’s who currently perform manipulation

    • % of their patients receiving manipulation

  • PT’s ability to assess contraindications to manipulation

  • DC’s ability to present a united front


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Solutions

  • Education

    • Define mobilization/ manipulation

    • Safety record of DC’s vs. others

    • Present to OPR, Board, Legislature prn


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Resources

  • FCLB

  • Becoming an expert

    • Definitions

    • PT’s practice

      • “medical” differential diagnosis vs.

      • PT diagnosis

    • Risks and benefits of manipulation



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